#SARS-CoV-2 reports

[rikaklassen]

CW: COVID-19

via @augieray@mastodon.social

Yes, I wish the general public takes COVID more seriously.

Coronavirus is not like the flu nor RSV and we've known about that since MERS and the first SARS. Also, massively disappointed with queer assimilationists since COVID is quite similar to HIV/AIDS and given how the government's eugenicist policies and their anti-LGBT campaigns wiped out many of the people who would have been elders in our communities today. Let's alone the deaf communities with the older generations of sign language folks becoming deaf and multi-disabled because of rubella, which is much more infectious than COVID.

I encourage you to read what Augie has to say since the screenshot is a snapshot of a five-parts thread.

Here is the spreadsheet where Augie took the time to read over 1 500 studies and summarized the findings of about 500 of them: https://docs.google.com/spreadsheets/d/12VbMkvqUF9eSggJsdsFEjKs5x0ABxQJi5tvfzJIDd3U/

[covid-safer-hotties]

Orange County Florida showing highest rates of covid in wastewater since monitoring began and rising. This is higher than their omicron peak. "The pandemic is over."

[jcsmicasereports]

Trends in incidence of COVID 19 based on performed Rapid Antigen Test by Piratheep kumar.R in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

The COVID 19 outbreak represents a historically unprecedented pandemic, particularly dangerous and potentially lethal for elderly population. The biological differences in the immune systems between men and women exist which may impact our ability to fight an infection including SARS-2-CoV-2. Men tended to develop more symptomatic and serious disease than women, according to the clinical classification of severity. Age-related changes in the immune system are also different between sexes and there is a marked association between morbidity/mortality and advanced age in COVID-19. This is a single-center, retrospective, data oriented study performed at the private hospital, in Central Province, Sri Lanka. The data of the patients who performed the Rapid Antigen Test (RAT) to know whether they have infected by SARS-CoV-2 or not, were taken for analysis. Test performed date, age, sex, number of positive and negative cases, number of male and female patients were extracted. Finally the data were analyzed in simple statistical method according to the objective of the study. Totally 642 patients performed RAT within the period of one month from 11.08.2021 to 11.09.2021. Among them 426 (66.35%) are male and 216 (33.64%) are female. 20.4% (n=131) of male obtained positive result among the total male population (n=426). Likewise 11.4% (n=73) of female obtained positive result among the total male population (n=216).  Large number of positive cases was observed (34.89%) between the age group of 31-40 years in both sexes. The age group of 21-30 and 41-50 years also were shared the almost same percentage (17.13% & 17.75). The large number of positive male patients observed among the age group of 41-50 years. Almost same number of patients was observed in the age group of 21-30 and 31-40. The least number of positive cases (0.7% and 0.9%) observed almost in 0-10 and 81-90 years. When considering the females, large number of positive female patients observed among the age group of 31-40 years.

Key words: Rapid Antigen Test, Covid-19, SARS-CoV-2

Introduction

A rapid antigen test (RAT) or rapid antigen detection test (RADT), is a rapid diagnostic test suitable for point-of-care testing that directly detects the presence of an antigen. It is used to detect SARS-CoV-2 that cause COVID-19. This test is one of the type of lateral flow tests that detect protein, differentiate it from other medical tests such as antibody tests or nucleic acid tests, of either laboratory or point-of-care types. Generally 5 to 30 minutes only will take to get result and, require minimal training or infrastructure, and cost effective (1).

Sri Lanka was extremely vulnerable to the spread of COVID-19 because of its thriving tourism industry and large expatriate population. Sri Lanka almost managed two waves of Covid-19 pandemic well, but has been facing difficulties to control the third wave. The Sri Lankan government has executed stern actions to control the disease including island-wide travel restrictions. The government has been working with its development partners to take necessary action to mobilize resources to respond to the health and economic challenges posed by the pandemic (2) (3).

The COVID 19 outbreak is dangerous and fatal for elderly population. Since the beginning of the actual SARS-CoV-2 outbreak there were an evident that older people were at higher risk to get the infection and develop a more severe with bad prognosis. The mean age of patients that died was 80 years. The majority of those who are infected, that have a self-limiting infection and do recover are younger. On the other hand, those who suffer with more severe disease require intensive care unit admission and finally pass away are older (4).

Sandoval.  M., et al mentioned that the number of patients who are affected by SARS-CoV-2 with more than 80 years of age is similar to that with 65–79 years. The mortality rate in very elderly was 37.5% and this percentage was significantly higher compared to that observed in elderly. Further their findings were suggested that the age is a fundamental risk factor for mortality (5).

Since February 2020, more than 27.7 million people in US have been diagnosed with Covid-19 (6). Rates of COVID-19 deaths have increased across the Southern US, among the Hispanic population, and among adults aged 25–44 years (7). Young adults are at increased risk of SARS-CoV-2 because of exposure in work, academic, and social settings. According to the several database of different health organizations young adult, aged 18-29, were confirmed Coid-19 (9).

Go to:Amid of coronavirus disease 2019 (Covid-19) pandemic, much emphasis was initially placed on the elderly or those who have preexisting health conditions such as obesity, hypertension, and diabetes as being at high risk of contracting and/or dying of Covid-19. But it is now becoming clear that being male is also a factor. The epidemiological findings reported across different parts of the world indicated higher morbidity and mortality in males than females. While it is still too early to determine why the gender gap is emerging, this article point to several possible factors such as higher expression of angiotensin-converting enzyme-2 (ACE 2; receptors for coronavirus) in male than female, sex-based immunological differences driven by sex hormone and X chromosome. Furthermore, a large part of this difference in number of deaths is caused by gender behavior (lifestyle), i.e., higher levels of smoking and drinking among men compared to women. Lastly, studies reported that women had more responsible attitude toward the Covid-19 pandemic than men. Irresponsible attitude among men reversibly affect their undertaking of preventive measures such as frequent handwashing, wearing of face mask, and stay at home orders.

The latest immunological study on the receptors for SARS-CoV-2 suggest that ACE2 receptors are responsible for SARS-CoV-2. According to the study by Lu and colleagues there are positive correlation of ACE2 expression and the infection of SARS-CoV (10). Based on the positive correlation between ACE 2 and coronavirus, different studies quantified the expression of ACE 2 proteins in human cells based on gender ethnicity and a study on the expression level and pattern of human ACE 2 using a single-cell RNA-sequencing analysis indicated that Asian males had higher expression of ACE 2 than female (11). Conversely, in establishing the expression of ACE 2 in the primary affected organ, a study conducted in Chinese population found that expression of ACE 2 in human lungs was extremely expressed in Asian male than female (12).

A study by Karnam and colleagues reveled that CD200-CD200R and sex are host factors that together determine the outcome of viral infection. Further a review on association between sex differences in immune responses stated that sex-based immunological differences contribute to variations in the susceptibility to infectious diseases and responses to vaccines in males and females (13). The concept of sex-based immunological differences driven by sex hormone and X chromosome has been well demonstrated via the animal study by Elgendy et al (14) (35). They were concluded the study that estrogen played big role in blocking some viral infection.

The biological differences in the immune systems between men and women may cause impact on fight for infection. Females are more resistant to infections than men and which mediated by certain factors including sex hormones. Further, women have more responsible attitude toward the Covid-19 pandemic than men such as frequent hand washing, wearing of face mask, and stay at home (15).

Most of the studies with Covid-19 patients indicate that males are mostly (more than 50%) affected than females (16) (17) (18). Although the deceased patients were significantly older than the patients who survived COVID-19, ages were comparable between males and females in both the deceased and the patients who survived (18).

A report in The Lancet and Global Health 5050 summary showed that sex-disaggregated data are essential to understanding the distribution of risk, infection and disease in the population, and the extent to which sex and gender affect clinical outcomes (19). The degree of outbreaks which affect men and women in different ways is an important to design the effective equitable policies and interventions (20). A systematic review and meta-analysis conducted to assess the sex difference in acquiring COVID-19 with 57 studies that revealed that the pooled prevalence of COVID-19 confirmed cases among men and women was 55% and 45% respectively (21). A study in Ontario, Canada showed that men were more likely to test positive (22) (23). In Pakistan 72% of COVID-19 cases were male (24). Moreover, the Global Health 5050 data showed that the number of COVID-19 confirmed cases and the death rate due to the disease are high among men in different countries. This might be because behavioral factors and roles which increase the risk of acquiring COVID-19 for men than women. (25) (26) (27).

Men mostly involved in several activities such as alcohol consumption, being involved in key activities during burial rites, and working in basic sectors and occupations that require them to continue being active, to work outside their homes and to interact with other people even during the containment phase. Therefore, men have increased level of exposure and high risk of getting COVID-19 (28) (29) (30).

Men tended to develop more symptomatic and serious disease than women, according to the clinical classification of severity (31). The same incidence also noticed during the previous coronavirus epidemics. Biological sex variation is said to be one of the reasons for the sex discrepancy in COVID-19 cases, severity and mortality (32) (33). Women are in general able to stand a strong immune response to infections and vaccinations (34).

The X chromosome is known to contain the largest number of immune-related genes in the whole genome. With their XX chromosome, women have a double copy of key immune genes compared with a single copy in XY in men. This showed that the reaction against infection would be contain both innate and adaptive immune response. Therefore the immune systems of females are generally more responsive than females and it indirectly reflects that women are able to challenge the coronavirus more effectively but this has not been proven (32).

Sex differences in the prevalence and outcomes of infectious diseases occur at all ages, with an overall higher burden of bacterial, viral, fungal and parasitic infections in human males (36) (37) (38) (39). The Hong Kong SARS-CoV-1 epidemic showed an age-adjusted relative mortality risk ratio of 1.62 (95% CI = 1.21, 2.16) for males (40). During the same outbreak in Singapore, male sex was associated with an odds ratio of 3.10 (95% CI = 1.64, 5.87; p ≤ 0.001) for ITU admission or death (41). The Saudi Arabian MERS outbreak in 2013 - 2014 exhibited a case fatality rate of 52% in men and 23% in women (42). Sex differences in both the innate and adaptive immune system have been previously reported and may account for the female advantage in COVID-19. Within the adaptive immune system, females have higher numbers of CD4+ T (43) (44) (45) (46) (47) (48) cells, more robust CD8+ T cell cytotoxic activity (49), and increased B cell production of immunoglobulin compared to males (43) (50). Female B cells also produce more antigen-specific IgG in response to TIV (51).

Age-related changes in the immune system are also different between sexes and there is a marked association between morbidity/mortality and advanced age in COVID-19 (52). For example, males show an age-related decline in B cells and a trend towards accelerated immune ageing. This may further contribute to the sex bias seen in COVID-19 (53).

Hence, this single center, retrospective, data oriented study performed to identify the gender age influences the RAT results and the rate of positive cases before and after the lockdown.

Methodology

This is a single-center, retrospective, data oriented study performed at the private hospital, Central Province, Sri Lanka. The data of the patients who performed the Rapid Antigen Test (RAT) from 11.08.2021to 11.0.2021 to know whether they have infected by SARS-CoV-2 or not, were taken for analysis. The authors developed a data extraction form on an Excel sheet and the following data from main data sheet. Test performed date, age, sex, number of positive and negative cases, number of female patients and number of male patients were extracted. Mistyping of data was resolved by crosschecking. Finally the data were analyzed in simple statistical method according to the objective of the study.

Results and discussion

Totally 642 patients performed RAT within the period of one month from 11.08.2021 to 11.09.2021. Among them 426 (66.35%) are male and 216 (33.64%) are female. Men mostly involved in several activities such as alcohol consumption, being involved in key activities during burial rites, and working in basic sectors and occupations that require them to continue being active, to work outside their homes and to interact with other people even during the containment phase. Therefore, men have increased level of exposure and high risk of getting COVID-19 (28) (29) (30). The present data descriptive study also were supported certain previous research findings.

The number of male patients got positive result in RAT among the total male patients who performed RAT on every day. According to that, 20.4% (n=131) of male obtained positive result among the total male population (n=426). Philip Goulder, professor of immunology at the University of Oxford stated that women’s immune response to the virus is stronger since they have two X chromosomes which is important when talk about the immune response against SARS-Cov-2. Because the protein by which viruses such as coronavirus are detected is fixed on the X chromosome. This is exactly looks like females have double protection compare to male. The present study also showed that large number of RAT positive cases were observed in males compare to females. Gender based lifestyle would have been another possibility for large number of males got positive in RATs. There are important behavioral differences between the sexes according to certain previous research findings (54).

Shows that the number of female patients got positive result in RAT among the total female patients who performed RAT on every day. According to that, 11.4% (n=73) of female obtained positive result among the total male population (n=216).

The relations between the number of positive cases before and after the lockdown. The lockdown declared by the tenth day from the initial day when the data was taken for analysis. The red vertical line differentiates the period as two such as before and after the lockdown. Though there was no decline observed as soon as immediately considerable decline was observed after the 21 days of onset of lockdown. Staying at home, avoiding physical contacts, and avoiding exposure in crowded areas are the best way to prevent the spread of Covid – 19 (54). However the significant decline would be able to see after three weeks only from the date of lockdown since the incubation period of SARS-CoV-2 is 14-21 days. The continuous study should be conducted in order to prove it. However the molecular mechanism of COVID-19 transmission pathway from human to human is still not resolved, the common transmission of respiratory diseases is droplet sprinkling. In this type of spreading, a sick person is exposed to this microbe to people around him by coughing or sneezing. Only the way to prevent these kind of respiratory diseases might be prevent the people to make close contact (54) (55). Approximately 214 countries reported the number of confirmed COVID-19 cases (56). Countries including Sri Lanka have taken very serious constraints such as announced vacation for schools, allowed the employers to work from home and etc. to slow down the COVID 19 outbreak. The lockdown days differ by countries. Countries have set the days when the lockdown started and ended according to the COVID-19 effect on their public. Some countries have extended the lockdown by many days due to COVID-19 continues its influence intensely on the public (57) (58).

The incidence of Covid-19 and age group. Accordingly large number was observed (34.89%) between the age group of 31-40 years in both sexes. The age group of 21-30 and 41-50 years also were shared the almost same percentage (17.13% & 17.75). A study provides evidence that the growing COVID-19 epidemics in the US in 2020 have been driven by adults aged 20 to 49 and, in particular, adults aged 35 to 49, before and after school reopening (59). However many researches pointed out that adults over the age of 60 years are more susceptible to infection since their immune system gradually loses its resiliency.

The relations between the positive number of male & female patients and the age group of total patients. According to that the large number of positive male patients observed among the age group of 41-50 years. Almost same number of patients was observed in the age group of 21-30 and 31-40. The least number of positive cases (0.7% and 0.9%) observed almost in 0-10 and 81-90 years. When considering the females, large number of positive female patients observed among the age group of 31-40 years. In USA Ministry of Health has reported 444 921 COVID-19 cases and 15 756 deaths as of August 31. For men, most reported cases were persons aged 30–39 years (22.7%), followed by 20–29 year-olds (20.1%) and 40–49 year-olds (17.1%). Most reported deaths were seniors, especially 70–79 year-olds (29.5%), followed by those aged 80 years and older (29.2%), and 60–69 year-olds (22.8%). Also found a similar pattern for women, except that most deaths were reported among women aged 80 years and older (44.4%) (60).

Conclusion

The present study showed that the male are mostly got positive in RAT test than female. Further comparing the old age young age group in both sexes were noticed as positive in RAT. Moreover there were no relationship observed before and after the lockdown and trend of Covid-19

 The limitations of the study

This study has several limitations.

Only 1 hospital was studied.

More than the absence of specific data on mobility patterns or transportation, detail of recovery, detail of mortality etc.

The COVID-19 pandemic is still ongoing so statistical analysis should continue. There are conflicting statements regarding lockdown by countries on COVID-19.

The effect of the lockdown caused by the COVID-19 pandemic on human health may be the subject of future work.

[pandemichub]

Please be aware, data not being collected does not mean there is no data. Reach out to your local representatives to push HARD for continued funding of waste water monitoring. It is the most reliable, and an incredibly vital resource. Without information about viral trends, it becomes quite uncertain how to proceed for the average person and for communities.

I posted an article awhile back about waste water monitoring finding quite potentially being in a precarious position. Furthermore this would lead to outbreaks and the general public being unawares and run afoul of horrible outcomes.

The work of aggregating and collating of data is being left to individuals, which is not only horrifying, unethical and well out of step with science based methods and guidance, but highly unusual given data is kept and provided for other illnesses, especially ones as severe and concerning as covid-19 (SARs CoV 2).

For the time being, I personally will be assuming transmission is moderate to high in addition to my sources. In the absence or great reduction of data and reports, greater estimations and assessment of made, and when only observations, assumed. Be as safe as you can everyone 💝 - Admin

Please be aware of what may no longer be offered, operating or an out of pocket cost. Masks, tests (all types), vaccines, remote options, COVID-19 tracking apps. Also be mindful of any local or nationwide level policies, proposals, news or trends that cite mask and other NPI removals, bans, stigma or efforts towards criminalization.

For the time being, the following resources remains invaluable:

https://biobot.io

It has come to my attention the person whose account is Laughter In Light has falsely claimed a prominent disability advocate encouraged or engaged in doxxing and slander with no demonstrable proof which has led to great harm. Laughter in light has provided some very helpful information throughout the pandemic. It is also important to be aware, critical and hold people into account for their actions, ideologies, commentary/statements and or stances. There are many other wonderful sources to inform oneself and stay up to date. - Admin

Provides regular updates on infectious diseases news

Sadly they don't have a website or any links I know of. Their Twitter is public however and can be viewed even without an account.

Give incredible analysis and updates on SARS CoV-2! Excellent medical and scientific communicator!

Stella has been amazing since the beginning and continues to be. Definitely worth following! Check out their link tree! They're also on Tiktok!

If anyone has any international resources for updates and tracking, please add it via reblog and I'll definitely share! - Admin

[tornadoquest]

Tornado Quest Top Science Links For June 8 - 15, 2024 #science #weather #climate #tornado #hurricane #drought

Greetings everybody! Thanks so much for stopping by. As severe weather and tornado activity continues, the Atlantic hurricane season is here as well. We’ll continue our overview of severe weather and tornado safety but also get into more details on hurricane preparedness. We also have our look at the latest US Drought Monitor update along with interesting science reads, so let’s get…

[xtruss]

CDC Update After COVID Variant BA.2.86 Detected in U.S.

— August 24, 2023 | Newsweek | By Pandora Dewan, Science Reporter

A man holding up a COVID-19 test. The CDC has issued a warning about new SARS-CoV-2 variant BA.2.86. Daria Nipot/Getty

There have been numerous variants of the SARS-CoV-2 virus so far, including the highly transmissible Omicron strain that made headlines in 2022. However, according to the CDC, the new BA.2.86 has even more additional mutations compared with previously detected Omicron variants.

The large number of mutations raises concerns that the new variant may be more effective at evading our existing immunity to the virus, either through vaccinations or previous infections. However, it is too soon to say how it will impact global immunity, as samples are not yet broadly available for lab-based antibody testing.

"Nearly all the U.S. population has antibodies to SARS-CoV-2 from vaccination, previous infection, or both, and it is likely that these antibodies will continue to provide some protection against severe disease from this variant," the CDC said. "This is an area of ongoing scientific investigation."

Only nine cases of the new strain have been confirmed so far: three in Denmark; two in South Africa; one in Israel; two in the U.S.; and one in the U.K. However, the variant has also been detected in U.S. waste-water samples.

With such a small number of confirmed cases, it is too soon to know how transmissible the new variant is, although its detection across multiple continents does indicate some degree of transmissibility.

The severity of disease caused by BA.2.86 is also unclear. "At this time, locations where this variant have been detected have not experienced increases in transmission indicators (e.g., cases, emergency department visits) or hospitalizations out of proportion to those seen in neighboring locations," the CDC said. "However, it is early in the emergence of this variant and too soon to evaluate impacts based on these indicators."

The good news is that, from what we know so far, the existing detection tests and medications used to treat COVID-19 appear to be effective against this new variant.

There are a lot of unknowns surrounding BA.2.86, but to stay safe, the CDC recommends the following actions:

Stay home if you are sick.

Get tested for COVID-19 if you feel flu-like symptoms.

Improve ventilation.

Wash your hands.

Get vaccinations as recommended by your health provider.

— Pandora Dewan is a Newsweek Science Reporter based in London, UK. Her focus is reporting on science, health and technology. Pandora joined Newsweek in 2022 and previously worked as the Head of Content for the climate change education start-up, ClimateScience and as a Freelance writer for content creators such as Dr Karan Rajan and Thoughty2. She is a graduate in Biological Sciences from the University of Oxford.

[submalevolentgrace]

From the earliest days of the COVID-19 pandemic, scientists have raised concerns about the potential for long-term health problems linked to SARS-CoV-2 and warned repeated infections are likely to increase the risk. An association between COVID and cardiovascular disease emerged quickly. And now — almost exactly four years since the first case was discovered in Wuhan — a growing body of scientific research is cautiously linking the inflammation caused by a COVID infection to diseases like Alzheimer's and Parkinson's as well as autoimmune conditions from bowel disease to rheumatoid arthritis. The virus has even been suggested to impact some pregnant women, associated with double the risk of premature delivery. As the eighth COVID wave hits Australia, experts are taking notice.

...

When the first wave of COVID patients began reporting loss of smell and taste, Barnham's radar went up. "Any time you see olfactory impairment it tells you that there's going to be neurological impact," he says. "Loss of smell is a cardinal, pre-clinical symptom of Parkinson's disease and it's been implicated in Alzheimer's disease as well." The fact that COVID patients reported loss of smell not only during the active phase of the disease, but as a persistent symptom, suggested to Barnham that longer-term health consequences were likely. Loss of smell is associated with loss of brain volume.

[tzifron]

Worldwide, there were more than 11,000 reported deaths from COVID between mid-December 2023 and mid-January 2024, and more than half of those deaths occurred in the U.S. In that same time frame, nearly one million cases were reported to the World Health Organization globally (although reduced testing and reporting means this is likely a vast undercount). In particular, epidemiologists are monitoring the newest variant of SARS-CoV-2, JN.1, and looking for any signs that it may be more severe than previous strains.

Although the WHO declared an end to the COVID public health emergency in May 2023, the organization has emphasized that the pandemic isn’t over—it’s just entered an endemic phase, which means that the virus will continue to circulate indefinitely.

[...]

How would you describe the overall state of COVID at this point in the pandemic?

COVID’s not in the news every day, but it’s still a global health risk. If we look at wastewater estimates, the actual circulation [of SARS-CoV-2] is somewhere between two and 20 times higher than what’s actually being reported by countries. The virus is rampant. We’re still in a pandemic. There’s a lot of complacency at the individual level, and more concerning to me is that at the government level.

[...]

"We understand you don’t want to hear about it. I don’t want to talk about it. But we need to because there’s more we can do. We cannot prevent all infections. We cannot prevent all deaths. But there’s a hell of a lot more that we can do to keep people safe and save them from losing a loved one"

[covid-safer-hotties]

Data Report - Pandemic News Aug 21, 2024

[thoughtportal]

https://www.news-medical.net/news/20220224/Study-reports-persistent-SARS-CoV-2-lingering-within-tissues-of-patients-with-long-COVID.aspx

https://www.nbcnews.com/health/health-news/long-covid-even-mild-covid-linked-damage-brain-months-infection-rcna18959

[jcsmicasereports]

Emerging infectious agents: an unusual case of Metapneumovirus pneumonia in an adult patient by Graziana Francesca Greco in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Human Metapneumovirus (hMPV), a relatively new virus, is a common cause of acute respiratory infection, especially common in the pediatric population. Despite hMPV infection in adults is possible, this rarely results in serious clinical manifestation. Here, we describe a hypoxemic respiratory failure related to pneumonia in an adult patient in whom hMPV was detected in respiratory samples.

Keywords

Human Metapneumovirus; SARS-CoV-2; Covid-19.

CASE HISTORY

A 61-yr-old caucasian man presented to the Emergency Department (ASST Mantua Hospital, Mantua, Italy) with fever up to 39°C, poorly responsive to antipyretics, nocturnal dyspnea and productive cough with mucus-purulent sputum for three days. On physical examination he appeared in good general condition, collaborating and oriented. The following parameters were recorded: blood pressure 140/90mmHg, heart rate of 100 beats min-1; respiratory rate of 23 breaths min-1; and body temperature of 38.4°C. His arterial oxygen saturation on room air was 87%. Chest examination revealed abnormal breath sounds with rhonchi and fine crackles in the middle lobe and inferior lobes bilaterally, no wheezes were heard. Laboratory findings revealed lymphocytosis (81000 x 103/µl), low platelet count (113000 x 106/µl) and an increase in alanine transaminase value (59 U/L), total bilirubin value (1.13 mg/dL) and CPR value (112 mg/L). Room air arterial blood gas analysis showed a normocapnic hypoxemia: pH 7.43, carbon dioxide tension 40.5 mmHg, oxygen tension 60.4 mmHg, and HCO3 24 mmol L-1. The  SARS-CoV-2 antigen detection test on nasopharyngeal swab was negative. A chest radiograph showed multiple, small, patchy opacities in the right upper and middle lobe and  no pleural effusion was observed. Based on these findings he was admitted to the Respiratory Department.

His medical history included chronic lymphocytic leukemia in follow-up which did not require any specific treatment. He denied taking any medications or to be a smoker, he drinks a glass of wine once a day and has no known allergies. The patient was a farmer who cultivates wheat and maize but he had no animal exposure and no travel history in the last few years. There is no family history or childhood history of respiratory complaints. He was vaccinated with three dosesagainst the SARS-CoV-2 infection (Pfizer) but not against the influenza virus.

Based on the patient’s presentation and testing results, on suspicion of bacterial pneumonia he was empirically treated with IV Piperacillin/Tazobactam, the patient required oxygen support at 3L min-1 and an inhalation therapy with Beclomethasone/Formoterol was set up ex adiuvantibus. In the following days, several microbiological investigations were carried out to determine the etiology of pneumonia: blood culture, urinoculture, sputum culture, Legionella, Haemofilus and Pneumococcus serologic tests, Legionella pneumophila and Pneumococcal urinary antigen test, all of which were negative.

A  nasopharyngeal swab FilmArray Respiratory Panel Assay (NP FARP) was then requested: it was positive for human Metapneumovirus and the result was confirmed by repeating the test. For non responder fever and further increase of CPR (230 mg/l) and PCT (0.27 ng/ml), Levofloxacin and later Meropenem were added in the perspective of a resistant bacterial etiology.  On  the 6th hospitalization day a chest computed tomography (CT) scan was obtained (Figures 1 and 2) which demonstrated large opacities with gradient borders, distributed in the peribronchial area at the right upper lobe, middle lobe and both the lower lobes; they tended to the confluence configuring parenchymal consolidations with aerial bronchogram at the level of the cost-phrenic angle. Imaging also showed bilateral hilar and mediastinal lymphadenopathy (max diameter 3.4 x 2 cm), splenomegaly and absence of pleural effusion. Blood chemistry tests for HIV, Aspergillus antigen and galactomannan were also investigated but turned out negative. To rule out other infectious agents the patient underwent bronchoscopy with bronchoalveolar lavage (BAL) into the middle lobe. BAL provides material for various microbiological and cytological tests: Gram stain, culture, Koch’s bacillus DNA, Galactomannan, Cytomegalovirus and P. Jirovecii and immunological analysis were negative. From respiratory virus panel on BAL only human Metapneumovirus was isolated, this unique microbiological data was according to the NP FARP’s result,  thus supporting and confirming the new hypothesis of a viral pneumonia in an adult patient with probable secondary mild immunosuppression due to his hematological disease. About ten days after entering the ward, there was a gradual decrease of CPR and a progressive improvement in clinical conditions and respiratory function to allow the suspension of oxygen therapy. At the end of hospitalization, pulmonary function tests were performed and showed a restrictive syndrome (FEV1/FVC 76.2, TLC 68% and VC 79% of predicted) and mild reduction of diffusion capacity (DLCO 62% and KCO 99%), probably representing the residual functional impairment due to viral pneumonia. The patient finally suspended all therapies and at discharge was referred for a one-month follow-up visit.

DISCUSSION

Human Metapneumovirus (hMPV), a relatively new virus first discovered in 2001, has been detected in 4-16% of patients with acute respiratory infections [1] [2] [3]. In particular, a recent review of 48 previous articles, including 100,151 patients under the age of five hospitalized for CAP, identified this virus as a cause of pneumonia in 3.9% of patients [4]. A recent study of 1386 hospitalized adult patients identified hMPV pneumonia in only 1.64%, indicating that it was much less common than in the infant population [5]. Metapneumovirus causes disease primarily in infants, but rarely can infect immunosuppressed individuals and elderly as well. Seroprevalence studies have shown that 90-100% of 5-10 years old children have previous infection [6]. Reinfection can occur during adulthood because of defected immunity acquired during the first contact with hMPV and/or because of different viral genotypes. The incubation period varies widely but is typically 3-5 days. The disease severity depends on the patient's condition and it ranges from mild upper airway infection to life-threatening pneumonia or bronchiolitis [7]. Clinically, Metapneumovirus infection is often indistinguishable from RSV infection, particularly in the pediatric population, and common symptoms include hypoxemia, cough, fever, upper and lower airway infections and wheezing [8]. hMPV infant patients are often hospitalized  for bronchiolitis and pneumonia [9]. In young adults, a flu-like syndrome with fever may occur in a small number of instances, but infection in geriatric subjects may cause severe clinical manifestations such as pneumonia and, in rare cases, death [10].

As described in this case, it was not surprising that antibiotics and corticosteroids were administered in most patients infected with Metapneumovirus mainly for two reasons: in most cases the specific diagnostic tests for hMPV are not carried out at admission and/or physicians prefer to continue steroid and antibiotic treatment to control potential unidentified bacterial infections in patients in which no etiological agent had been identified associated with hMPV infection. The overuse of these drugs could therefore be reduced through the adoption at admission of specific diagnostic tests for such etiological agent, especially if specific risk factors are present (age, immunodepression, etc.). In addition, the adoption of such tests could reduce the nosocomial spread of this virus, allowing an early isolation of the infected patient [11].

Conflicts of interest: The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. Funding: The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.

Authors’ contributions : All authors contributed equally to the manuscript and read and approved the final version of the manuscript.

[pandemichub]

"👋I’m back. And I wrote about the current wave of attempts to downplay long COVID—less outright denial & more "it’s real but no big deal". Except: it very much is. It’s a substantial and ongoing crisis that still demands our attention. 1/" - Ed Young

[mindblowingscience]

A monoclonal antibody appears effective at neutralizing the numerous variants of SARS-CoV-2, as well as related viruses in animals that could pose a threat if they were to begin spreading in people. The antibody, called SC27, was recently described in an article published in Cell Reports Medicine. The finding opens the possibility of broader, more effective treatments to work against current and future COVID variants.

Continue Reading.

[lotus-tower]

COVID-19's long-term effects on the body: an incomplete list

COVID’s effect on the immune system, specifically on lymphocytes:

NYT article from 2020 (Studies cited: https://www.biorxiv.org/content/10.1101/2020.05.18.101717v1, https://www.biorxiv.org/content/10.1101/2020.05.20.106401v1, https://www.unboundmedicine.com/medline/citation/32405080/Decreased_T_cell_populations_contribute_to_the_increased_severity_of_COVID_19_, https://www.medrxiv.org/content/10.1101/2020.06.08.20125112v1)

 https://www.biorxiv.org/content/10.1101/2022.01.10.475725v1

https://www.science.org/doi/10.1126/science.abc8511 (Published in Science)

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057012/

https://www.forbes.com/sites/williamhaseltine/2022/04/14/sars-cov-2-actively-infects-and-kills-lymphoid-cells/

https://www.cleveland.com/news/2022/10/in-cleveland-and-beyond-researchers-begin-to-unravel-the-mystery-of-long-covid-19.html

SARS-CoV-2 infection weakens immune-cell response to vaccination: NIH-funded study suggests need to boost CD8+ T cell response after infection

https://www.merckmanuals.com/professional/hematology-and-oncology/leukopenias/lymphocytopenia

https://thetyee.ca/Analysis/2022/11/07/COVID-Reinfections-And-Immunity/

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

https://www.frontiersin.org/articles/10.3389/fimmu.2022.1034159/full

https://www.n-tv.de/politik/Lauterbach-warnt-vor-unheilbarer-Immunschwaeche-durch-Corona-article23860527.html (German Minister of Health)

Anecdotal evidence of COVID’s effects on white blood cells:

 https://twitter.com/DrJohnHhess/status/1661837956875956224

 https://x.com/TristanVeness/status/1661565201345564673

https://twitter.com/TristanVeness/status/1689996298408312832

Much more if you speak to Long Covid patients directly!

Related information of interest:

China approves Genuine Biotech's HIV drug for COVID patients

COVID as a “mass disabling event” and impact on the economy:

https://www.ctvnews.ca/health/report-says-long-covid-could-impact-economy-and-be-mass-disabling-event-in-canada-1.6306608

https://x.com/inkblue01/status/1742183209809453456?s=20

COVID’s impact on the heart:

https://www.dailystar.co.uk/news/world-news/deadly-virus-could-lead-heart-31751263 (Research from: Japan's Riken research institute)

https://www.brisbanetimes.com.au/national/queensland/unlike-flu-covid-19-attacks-dna-in-the-heart-new-research-20220929-p5bm10.html

https://www.mdpi.com/2077-0383/12/1/186

https://medicalxpress.com/news/2023-04-mild-covid-effects-cardiovascular-health.html

https://publichealth.jhu.edu/2022/covid-and-the-heart-it-spares-no-one

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/is-coronavirus-a-disease-of-the-blood-vessels (British Heart Foundation)

COVID’s effect on the brain and cognitive function:

https://www.openaccessgovernment.org/article/brain-infection-by-sars-cov-2-lifelong-consequences/171391/

https://www.cidrap.umn.edu/covid-19/study-shows-covid-leaves-brain-injury-markers-blood

https://www.theguardian.com/world/2020/jul/08/warning-of-serious-brain-disorders-in-people-with-mild-covid-symptoms

Cognitive post-acute sequelae of SARS-CoV-2 (PASC) can occur after mild COVID-19 

Neurologic Effects of SARS-CoV-2 Transmitted among Dogs

https://journals.lww.com/nsan/fulltext/2022/39030/neurological_manifestations_and_mortality_in.4.aspx

https://www.salon.com/2023/06/17/new-evidence-suggests-alters-the-brain--but-the-extent-of-changes-is-unclear/

https://www.scientificamerican.com/article/covid-virus-may-tunnel-through-nanotubes-from-nose-to-brain/

https://neurosciencenews.com/post-covid-brain-21904/

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext

https://medicalxpress.com/news/2022-08-covid-infection-crucial-brain-regions.html

https://news.ecu.edu/2022/08/04/covid-parkinsons-link/

Covid as a vascular/blood vessel disease:

https://www.salon.com/2020/06/01/coronavirus-is-a-blood-vessel-disease-study-says-and-its-mysteries-finally-make-sense/

https://www.salon.com/2023/12/27/brain-damage-caused-by-19-may-not-show-up-on-routine-tests-study-finds/

https://www.nih.gov/news-events/news-releases/sars-cov-2-infects-coronary-arteries-increases-plaque-inflammation

https://www.mdpi.com/2077-0383/12/6/2123

https://www.sciencedaily.com/releases/2021/10/211004104134.htm (microclots)

Long Covid:

Post-COVID-19 Condition in Canada: What we know, what we don’t know, and a framework for action

 https://www.ctvnews.ca/health/coronavirus/more-than-two-years-of-long-covid-research-hasn-t-yielded-many-answers-scientific-review-1.6235227

 https://www.cbc.ca/news/canada/london/cause-of-long-covid-symptoms-revealed-by-lung-imaging-research-at-western-university-1.6504318

 https://www.cbc.ca/news/canada/montreal/long-covid-study-montreal-1.6521131

https://news.yale.edu/2023/12/19/study-helps-explain-post-covid-exercise-intolerance

Other:

- Viruses and mutation: https://typingmonkeys.substack.com/p/monkeys-on-typewriters

Measures taken by the rich and world leaders

Heightened risk of diabetes

https://jamanetwork.com/journals/jama/fullarticle/2805461

https://www.nature.com/articles/d41586-022-00912-y

Liver damage:

https://timesofindia.indiatimes.com/city/mumbai/46-of-covid-patients-have-liver-damage-study/articleshow/97809200.cms?from=mdr

tl;dr: covid is a vascular disease, not a respiratory illness. it can affect your blood and every organ in your body. every time you're reinfected, your chances of getting long covid increase.

avoid being infected. reduce the amount of viral load you're exposed to.

the gap between what the scientific community knows and ordinary people know is massive. collective action is needed.

[pandemic-info]

COVID patients breathe large amounts of virus early on - Northwestern Now

It is the first longitudinal, direct measure of the number of SARS-CoV-2 viral copies exhaled per minute over the course of the infection — from the first sign of symptoms until 20 days after. On day eight, exhaled levels of virus drop steeply, down to near the limit of detection — an average of two copies exhaled per minute. Northwestern investigators tested breath samples — collected multiple times daily from 44 individuals — over the entire course of infection to determine when a person is most infectious.

...

“The vast majority of research on viral loads over the course of a COVID-19 infection has been based on nasal or oral swabs, which measure virus in the nose or throat,” said lead study author Gregory Lane, senior research project manager in Zelano’s lab. “However, SARS-CoV-2 is spread through breath, and virus on the breath may not match virus in the nose. The dynamics of viral shedding on breath over the course of infection are poorly understood, despite the fact that this is how the virus spreads.”

See also:

[willowreader]

We desperately need a vaccine that works for all variants.